Complete List of Valid ICD10 Codes
CMS has posted a complete list of the 2016 ICD-10-CM valid codes and code titles on the 2016 ICD- 10-CM and GEMs web page. The file is named icd10cm_codes_2016.txt. This file will be useful for physician offices and other providers who want to check to make sure that they are reporting all characters in a valid ICD-10-CM code. The codes are listed in tabular order (the order found in the ICD-10-CM code book). This list should assist providers who are unsure if additional characters are needed, such as the addition of a 7th character in order to arrive at a valid code.
BMI, Calculating It will Provide Clinical Support to Anesthesia
Anesthesia groups should educate providers and focus on the pre-evaluation documentation to help support the specific risk factors or medical conditions that validate the need for an anesthesia provider. A perfect example is the documentation for morbid obesity. We see this written on the records but many of the policies we are seeing state that the BMI must be greater than 40. Rarely do we see documentation that gives the patient’s exact BMI so that the record would clearly support the policy if audited. Having a focused audit on the pre-evaluations for MAC services would be a very good step for anesthesia compliance programs.
This issue is not new and it is not going away. As we have predicted, more and more carriers are limiting payment for these services. Anesthesia billing professionals and managers should monitor the draft policies and immediately go into action by working with their state societies when the draft policies are issued.
In addition, anesthesia groups should develop financial policies that can be presented to the patient up front that explains medical necessity limitations from the carrier and gives the patient an option to pay for the services personally. While this does put anesthesia groups in unfamiliar territory of collecting payments at time of service, getting paid for the services will be necessary, if a group is to survive.
